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Competing Interests: We declare no competing interests.

Objective: Acute non-traumatic digestive surgical emergencies are a frequent cause of emergency in Africa. We undertook this study to investigate the morbidity and mortality of these patients in Cameroon, a developing country in Central Africa., Patients and Methodology: This was an analytical cross-sectional study with prospective data collection, over a period of eight months (November 2019 to July 2020), at the Yaoundé central hospital (Cameroon). The latter is a second category (intermediate) public health facility in the Cameroon health pyramid, mainly welcoming patients without health insurance. All patients operated on for an acute non-traumatic digestive abdomen were included. The patients were followed up until the 12 th postoperative week. We used Cox univariate regression to determine factors associated with the occurrence of postoperative complications. The significance threshold retained was 0.05., Results: We collected 120 patients, representing 14.6% of all surgical emergencies. The mean age of the patients was 37.6 ± 13.5 years. Eighty (66.7%) were male with a sex ratio of 2. The two main preoperative diagnoses were acute generalized peritonitis (n = 58 or 48.3%) and intestinal obstruction (n = 38 or 31.7%). The two main etiologies were peptic ulcer perforation (n = 35) and acute appendicitis (n = 24). The delay between the onset of symptoms and consultation was 1.9 day and an average of 36.8 hours elapsed between diagnosis and surgery. During postoperative time the morbidity and mortality rates were 33.3 and 10%, respectively. Postoperative complications were mostly minor according to the Clavien-Dindo classification, with 21 cases of grade I (33.8%) and 12 cases of grade II (19.3%). The main cause of death was sepsis (8 out of 12 cases). We identified seven factors significantly associated with an increased risk of postoperative complications among whom three were modifiable: The consultation delay greater than 72h (p = 0.02), the time between diagnosis and the surgical intervention greater than 48h (p = 0.01) and the operating time greater than 2h (p = 0.05)., Conclusion: In our context, the results of the surgical management of acute non-traumatic abdomens of digestive origin are marked by high morbidity and mortality. The possible solutions are: the organization of public awareness campaigns to prompt rapid consultation in the event of acute abdominal pain, the establishment of universal health coverage as well as the improvement of technical platforms., (Copyright © 2021 SFMTSI.)

Objectives: High Blood Pressure (HBP) is a worldwide public health problem. It can be particularly severe in the Black race. Recent studies in Cameroon, showed an alarming prevalence, leading us to want to study the epidemiological, clinical, therapeutic and evaluative aspects of severe, (BP op to 180/110mmHg), recently diagnosed HBP in Yaounde. Our objective was to determine its clinical presentation and evolution., Methods: We conducted nine months prospective cohort study, from January to September 2016. We recruited from the active population participants who voluntarily accepted blood pressure screening offered in various localities in Yaounde, and were aged from 18 years and above., Results: Of a total of 6519 people who participated in the screening, 1875 (28.8%.), presented a HBP and 363 (5.6%) had severe HBP. Our cohort comprised 153 (42.1%) of these individuals with sustained severe hypertension, not on medication, who accepted the invitation to participate in the study. The range of 45-54 years and 55-64 years were the most represented; the sex ratio was 0.9. The cardiovascular risk factors number range from 5 to 8 with a median of 6. Systolic BP ranged from 184 to 225mmHg with a median of 200mmHg; while the diastolic BP ranged between 111-132.5mmHg with a median of 119mmHg. Kidney injury (77.8%) was the main complications. We identified 3 clinical forms: hypertensive emergencies 121 (79.1%) cases and hypertensive crises 32 (20.9%) cases. In these two groups, 33 (21.6%) patients presented with "super HBP" (a blood pressure>250/150mmHg). The average rate of BP control over 6 month was 39%. The main cause of poor BP control was lack of therapeutic compliance. We registered one death at the 3rd month of follow up due to acute kidney injury., Conclusion: Severe HBP prevalence in Yaounde is high in the active fraction of the population insidiously affected. Particularly, unsuspected renal impairment appears to be the major complication. The bad blood pressure control is linked to poor therapeutic observance and persistence., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

Introduction: hepatitis C virus (HCV) has several extra-hepatic manifestations including cryoglubulinemia. Cryoglobulinemia is defined as the abnormal presence in the blood of one or several proteins (cryoglobulins) that can precipitate at low temperatures., Method: We conducted a cross-sectional analytical study in the Laboratory of Biology and in the Unit of Hepatology of the General Hospital in Douala (HGD) over a period of 6 months. All patients agreeing to participate to the study and with anti-hepatitis-C antibodies under treatment or not were enrolled. Cryoglobulins were detected using biuret method and the classification was performed using Brouet immunoelectrophoresis. A multivariate analysis was conducted, confounding factors such as age, sex and the length of time after Hepatitis C Virus screening were adjusted., Results: The study enrolled 116 patients. The average age of patients was 58.47±9.95 years. Male sex accounted for 50.86% of cases. Arthralgia was found in 69.80% of cases. Cryoglobulin was found in 63.80% of patients. After adjustment, female sex (OR =2.18; CI 95% [0,97-4,90]; p= 0.059), asthenia alone (OR =2.45;CI 95% [1,04-5,80]; p= 0.041), asthenia combined with arthralgia (OR =2.84;CI 95% [1,13-7, 10]; p= 0.026) and the presence of HCV RNA (OR =2.84;CI 95% [1,13-7,10]; p= 0.028) were factors independently associated with the presence of cryoglobulin., Conclusion: The prevalence of cryoglobubin is high in patients with anti-hepatitis-C antibodies at the HGD. Simple biological methods are used to detect it. Cryoglobulin test in patients with HCV is essential in resource-limited countries., Competing Interests: Les auteurs ne déclarent aucun conflit d’intérêts., (© Servais Albert Fiacre Eloumou Bagnaka et al.)

Introduction: Rare diseases have, in certain cases, oral manifestations. These are often understudied; this helps to limit oral care services to this category of patients. This study aims to determine the epidemiology and clinical features of oral manifestations in patients with rare diseases in our environment., Methods: We conducted a cross-sectional descriptive study in two referral hospitals in Yaoundé over a period of 7 months. Data were collected from patients' medical records, parents' or guardians' interview and oral examination. The threshold significance level was p< 0.05., Results: Oral manifestations associated with rare diseases vary based on the group of conditions, teeth and often have functional consequences. Functional impairment was diagnosed in 97.2% of cases. Patients with deciduous dentition (59.4%) most commonly developed anomalies of tooth shape and position (conicity 7/22 cases, 32%) while patients with permanent teeth most commonly developed carious lesions (7/10 cases, 70%) and anomalies in tooth structure (4/10 cases with dental wear). A significant link between type of tooth, anomalies in tooth structure (p=0.001) and tooth numbers was found (p=0.018). Mastication problems (p=0.023) as well as suction problems (p=0.033) were linked to rare disease patient groups., Conclusion: Oral lesions in patients with rare diseases, although present in our environment, are often neglected. Oral care should be integrated within the basic package of oral health care trainings after the establishment of free or affordable health care for patients with disabilities or with specific needs., Competing Interests: Les auteurs ne déclarent aucun conflit d’intérêts.

Purpose: To measure lacrimal secretion and to investigate dry eye symptoms in chronic hemodialysis patients., Patients and Methods: This was a cross-sectional descriptive study carried out in the hemodialysis center of Douala General Hospital from June to August 2016. The degree of symptomatology related to dry eye was assessed by the Ocular Surface Disease Index (OSDI) questionnaire. Lacrimal secretion was measured by the Schirmer test without anesthesia. We defined normal as wetting>10mm and hyposecretion as a value≤10mm after 5minutes., Results: Thirty-five patients were involved in the study, 16 men (45.7%) and 19 women (54.3%) for a total of 70 eyes examined. The mean age was 41.9 years, with an average duration of dialysis of 35.5 months±30.2. The symptoms were "normal" for 21 patients (60%), "minimal" for 5 (14.3%), "moderate" for 8 (22.9%) and "severe" for 1 (2.8%). Lacrimal hyposecretion was found in 19 eyes (27.1%). It was severe in 8 eyes. A correlation was found between diabetes, gender and hyposecretion., Conclusion: Hemodialysis patients are likely to develop lacrimal hyposecretion mostly because of comorbities. It is therefore important to systematically evaluate lacrimal secretion in these patients., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

It is generally agreed today that digital technology provides a lever for improving access to health care, care processes, and public health planning and activities such as education and prevention. Its use in countries that have reached a given level of development has taken place in a somewhat fragmented manner that raises important interoperability problems and sometimes makes synergy impossible between the different projects of digital health. This may be linked to several factors, principally the lack of a global vision of digital health, and inadequate methodological knowledge that prevents the development and implementation of this vision. The countries of Africa should be able to profit from these errors from the beginnings of digital health, by moving toward systemic approaches, known standards, and tools appropriate to the realities on the ground. The aim of this work is to present the methodological approaches as well as the principal results of two relatively new centers of expertise in Mali and Cameroon intended to cultivate this vision of digital governance in the domain of health and to train professionals to implement the projects. Both centers were created due to initiatives of organizations of civil society. The center in Mali developed toward an economic interest group and then to collaboration with healthcare and university organizations. The same process is underway at the Cameroon center. The principal results from these centers can be enumerated under different aspects linked to research, development, training, and implementation of digital health tools. They have produced dozens of scientific publications, doctoral dissertations, theses, and papers focused especially on subjects such as the medicoeconomic evaluation tools of e-health and health information technology systems. In light of these results, we can conclude that these two centers of expertise have well and truly been established. Their role may be decisive in the local training of participants, the culture of good governance of digital health projects, the development of operational strategies, and the implementation of projects.

Introduction: Genital tract integrity is not always mantained during childbirth. No treatment protocol for post-partum perineal wounds (tears and episiotomies) existed in our Department, thus their management depends upon clinician. This study aimed to establish the role of antibiotic in the treatment of post-partum perineal wounds as well as the impact of antibioprophylaxis on wound healing and on prevention of infectious complications after repair., Methods: We conducted a prospective cohort study in the Department of Gynecology and Obstetrics at the Central Hospital of Yaoundé over a period of 6 months, from 1 January to 31 May 2016. Post-partum women with perineal tear and/or episiotomy were divided into two groups (A and B) and followed up. The group A was composed by 85 post-partum women under treatment protocol based on compresses soaked in Betadine ® (placebo). The Group B (or test group) was composed of post-partum women who had received placebo plus antibiotic (oral amoxicillin/clavulanic acid 875 mg/125 mg twice a day for 05 days). Both groups were followed up on day 0, day 2 and day 9. Our criteria for the evaluation of treatment were: pain, infection, swelling, cleanliness of the wounds and average healing time. Data were collected and analyzed using the software Epidata analysis version 3.2 and STATA version 12.0 (Texas USA 2001). The correlations between the variables were identified by chi-square, odds ratio and p value (using any p-value ≤ 0.05 as statistical significance cut-off) according to the case., Results: The average age was 26.32 ± 6.5 years, ranging between 15 and 43 years. Primiparous women accouted for 55.9% of the study population. At day 0 post-partum the main symptom was pain, without significant predominance of a group (OR = 0.9; CI = 0.14-7.19; p = 1). Swollen wounds were the second complaint, without significant variation between the two groups (OR = 1.69; CI = 0.88-3.24; p = 0.13). At day 0, day 2 and day 9 no significant variation was observed between the two treatment protocols with regard to the indicators analyzed: pain evolution, infection, swelling and average healing time. At day 9 the healing was complete in both groups and the two treatment protocols were shown to be equivalent in their effectiveness and prevention of infections., Conclusion: At the end of this study the two treatment protocols were shown to be equivalent. Antibiotics should not be prescribed for perineal wounds in order to contain the healthcare costs.

Background: This study aimed to evaluate and document the importance of Burnout syndrome among generalist medical doctors (GMD) since no investigation have been carried in Cameroon., Methods: Cross-sectional study including 85 GMD using a self-administered questionnaire on socio-demographic characteristics, socioprofessional conditions, Maslach Burnout Inventory - Human Services Survey (MBI-HSS) to evaluate burnout, and Ricci-Gagnon physical activities level metrics., Results: 77 GMD (90.6 %) reported having never heard about burnout. Mean age was 29 years (range 24-42 years). The MBI-HSS revealed that 36 GMD (42.4 %) were victims of burnout, with 27 (31.8 %) at a low level, 8 (9.4 %) moderate and one (1.2 %) severe. Burnout was associated with distance from home to job place (p ⟨ 0.05), strenuous job (p = 0.04), number of children in charge (p = 0.007), number of hospital attended (p = 0.003), number of hours of labor per day (p = 0.0001), conflicts with the hierarchy (p = 0.01), number of guards per month (p = 0.01). Physical activities practice did not showed significant preventive effect on burnout (p = 0.3) (Odds-ratio = 1.45, IC 95 % 0.6, 3.45)., Conclusions: Burnout syndrome is not well known among GMD in Douala, though having a high prevalence. Various socio-demographic and socio-professional factors are associated and contribute to increase the level of affect. Burnout seems to be a vicious somato-psycho-somatic disorder. This study did not found a protective or preventive effect of physical activities on burnout.

Introduction: Surgical Site Infections (SSI) cause morbi-mortality and additional healthcare expenditures. Developing countries are the most affected. The objective was to estimate the pooled incidence of SSI in Sub-Saharan Africa and describe its major risk factors., Methods: Systematic review and meta-analysis were conducted using the databases of the World Health Organization Regional Office for Africa, PubMed and standard search to select electronic articles published between 2006 and 2015. Only articles investigating SSI impact and risk factors in Sub-Saharan African countries were retained., Results: Out of 95 articles found, 11 met the inclusion criteria. Only 9 countries out of 45 have contributed, with a huge amount of information coming from Nigeria (5 articles out of 11). The impact of SSI ranged from 6.8% to 26% with predominance in general surgery. The pooled incidence of SSI was 14.8% (95% CI: 15,5-16,2%) with significant heterogeneity according to the specialty and the method of monitoring. Most cited risk factors were long procedure length and categories 3 and 4 of Altemeier contamination class. Other factors included hospital environment, inadequate care practices and underlying pathologies., Conclusion: SSI incidence is high in Sub-Saharan Africa. Studies in this area could improve knowledge, prevention and control of these multiple risk factors., Competing Interests: Conflits d’intérêts Les autueurs ne déclarent aucun conflit d'intérêts.

The present research evaluated the antidiabetic and antioxidant properties of M. lucida stem bark (50 and 500mg/kg) and glibenclamide (25mg/kg, standard drug) in acute (Oral glucose tolerance test) and sub-acute (Streptozotocin 60mg/kg, i.p. diabetic model) administration. A group of healthy rats constituted the normal control. The sub-acute experiment lasted 28 days during which water, food intake and weight gain were measured and biochemical parameters analyzed in both plasma and erythrocytes at the end of the experiment. The chemical substances present in M. lucida bark extract were determined. In the Oral glucose tolerance test, the reduction of blood glucose level was statistically significant for both M. lucida extracts and glibenclamide. However, in the diabetic rats acute administration of 500mg/kg extract had better blood sugar lowering effect than glibenclamide, which was better than 50mg/kg extract. Streptozotocin diabetic animal model was characterized by a decrease in weight gain, erythrocyte SOD and CAT activities and an increase in water and food consumption, lipid peroxidation, cholesterol, triglycerides, plasma glucose, creatinine and urea concentrations, and transaminases activities. M. lucida extract and glibenclamide significantly prevented the alteration of these parameters, thus indicating a corrective effect on diabetes and its complications. This study justifies the traditional claim and provides a rationale for the use of M. lucida to treat diabetes. Its antioxidant properties may serve to curb oxidative stress and hence prevent the diabetic complications related to oxidative stress. Chemical substances, which may be accountable for the antidiabetic and antioxidant properties of M. lucida were detected in the aqueous extract of M. lucida bark.

Unlabelled: The technical quality, interpretation, and clinical utility of diagnostic imaging examinations can increase considerably when the request forms are correctly filled out. This study sought to evaluate the completeness of these request forms at the Women and Children's Hospital in Yaoundé, Cameroon, to the 8 criteria established by the French High Health Authority (HAS, France)., Methods: This cross-sectional study evaluated 118 request forms for ultrasounds, 110 for conventional radiography, and 34 for computed tomography (CT scans), all completed by physicians at our university-affiliated hospital. They were sampled consecutively three days a week for several weeks, on days randomly selected at the beginning of each week, to minimize bias and ensure that as many different physicians as possible were assessed. We doubled the sample size recommended by the HAS. Conformity was defined by the presence of the required data on the request forms (data classified as either administrative or clinical)., Results: Overall, 52 request forms (19.8%) had all 5 administrative items, but only 9.2% had all 3 clinical components. Only 3 forms (1.1%) were 100% complete, including all 8 items; 85% included at least 5 components, and 35.1% had 6. The patient's last name was always included. Only 4.2% of the request forms included the prescriber's telephone number; 8% did not include the date and 17.2% (n = 45) did not state the clinical findings. On 30% of the forms, symptoms were the only clinical information listed; 23.7% (n = 62) stated the purpose of the examination (that is, the diagnosis to be confirmed or ruled out). The rate of missing information was highest in the requests for conventional radiography (49.5% compared to 38% with ultrasound and 12.3% for CT scans)., Conclusion: The request forms for imaging examinations provided inadequate administrative and clinical data, especially those for conventional radiography. This missing information makes it harder to perform and interpret these examinations. An electronic request form with mandatory fields might improve the overall quality of the forms.

Synovial osteochondromatosis is a disease characterized by a benign metaplastic cartilaginous proliferation. There are very few studies on synovial osteochondromatosis in Sub Saharan Africa. We report on 10 observations., We conducted a retrospective study carried out from January 2004 to December 2008, in Synovial osteochondromatosis patients attending the Rheumatology Unit of the Yaounde Central Hospital. We studied 3 women and 7 men, with an average age of 27 years±13 (range: 14 and 89 years old). The knee was the most affected joint (observed in 9 cases) and the metacarpophalangeal joint of the thumb was affected in 1 case. Pain was constant, and joint motion limitation was observed in 6 cases, swelling of the joint in 4 cases, cracking of the joint in 2 cases and nodules were noted in 1 case. None of these patients presented an inflammatory syndrome. Radiological signs were: calcified chondromas in all 10 cases, associated with degenerative lesions in 3 cases. Every patient received an analgesic and a non-steroidal anti-inflammatory medication. Only 3 patients (patients 1, 4 and 5) underwent surgical synovectomy. None of the patients underwent arthroscopic surgery or synoviorthesis., Synovial osteochondromatosis manifestations in our patients were similar to what has been described in the literature, only differing in that surgical care was not constant., (Le comitée de rédaction se réserve le droit de revoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de sonserver un examplaire du manuscrit, des figures et des tableaux.)

A retrospective study covering the period from March 2002 to December 2008 at the Yaounde Women's and Children's Hospital sought to identify the causes of blindness and severe visual impairment in children younger than 5 years old. Of the 55 cases recorded (prevalence: 2.4%), 33 patients were boys and 22 girls. Total blindness were found among 69% of the group, while 31% had severe visually impairment. The most frequent anatomical sites of the disease leading to blindness and severe visual impairment were the lens (27.3%), the visual cortex (25.5%) and the retina (14.5 %). As the initial prognosis is severe, close collaboration between all those responsible for these children must be set up to enable early specialised management and education.

Purpose: The purpose of this article is to present the results of a descriptive and retrospective study of the operations of the emergency medical assistance service (SAMU) in Yaounde, Cameroon., Methods: Medical regulation and intervention records and monthly statistics forms were analysed for the period going from the creation of the SAMU in 2004 to March 2007. Study was limited to call reception, medical regulation, and extra-hospital and training activities. Study focused on operations and services., Results: The SAMU in Cameroon is managed by a pilot committee presided by the Minister of Public Health and headed by a technical executive secretary. The single phone number to contact SAMU Yaoundé is 19 (119). When a call comes, the personnel on duty in the regulation room identifies the caller and either gives a non-medical response or transfers the call to an on-call emergency doctor who decides whether or not on-site intervention is required. In the 3-year study period, the SAMU received 50,822 calls per year (mean, 1694 +/- 2195). There were 1 596 prank calls (3.14%), 31 044 (61.08%) calls requesting non-medical information, and 2054 (4.04%) calls requiring on-site intervention. The number of calls decreased by 23% from the first to third year of operation. The number of on site-interventions carried out by Yaoundé SAMU was 578 in the first year, 651 in the second and 825 in the third year. A total of 1555 interventions were carried out including 142 that ended in no action and 107 that ended in late arrival. Road traffic accidents were the main reason for intervention. Only one training session was organised for the personnel during the first year of operations., Conclusion: The SAMU Yaoundé is based on the French model (on-site care). The number of calls has dropped from the first to third year but the number of prank calls has also decreased. Road traffic accidents accounted for most of the on-site interventions. Further work is needed to increase public awareness of the importance of the SAMU and to provide training for SAMU personnel.

The purpose of this study was to describe the sociodemographic, psychopathologic and criminological features associated with homicide based on review of expert psychiatric court reports describing murder and attempted murder perpetrators examined at Jamot Hospital in Yaoundé, Cameroon. The study cohort comprised reports describing 12 offenders who were examined at the request of ajudge or public prosecutor from March 1, 2002 to July 31, 2006. There were 8 men (66.7%) and 4 women (33.3%) with a mean age of 18.3 years (range, 17 to 43 years). In 8 cases the criminal act coincided with a difficult period in the offender's life. In the remaining 4 cases the act could not be linked to a specific life event. Assaults were carried out by strangulation, battery, or stabbing (knifes or machetes) in 87.5% of cases and occurred at the victim's home in 68.8% of cases. The main mental disorders diagnosed using the ICD-10 classification were schizophrenia in 41.7% of cases (n = 5), chronic delirium in 25.0% (n = 3), and personality disorder in 8.3 % (n = 1). Nine offenders (75.0%) had a history of mental disorder including 8 within at least six months preceding the assault. Four offenders had already received psychiatric treatment including 2 who required hospitalization following one or more episodes of psychotic decompensation. There were a total of 16 victims including 14 that died and 2 that were seriously wounded but survived thanks to prompt medical attention. The victims included 8 males and 8 females with 11 children (68.7%) and 5 adults (31.3%). In the child group 9 victims died (81.8%) and 2 survived (18.2%). Except one 17-year-old teenager, the 6 female and 3 male child victims were between the ages of 18 months and 8 years. The adult victims included 1 female and 4 males. The main findings of this study were the high incidence of mental disease, especially schizophrenics (66.7%), associated with homicide and the high number of child victims (62.5%). The first finding underlines the public danger of releasing mental patients without psychiatric care or assistance. The second finding highlights the special vulnerability of children and raises questions about the need for special protection and preventive measures.

Aim: To determine the bone mineral density (BMD) of Cameroonian woman and the importance of primary osteoporosis of the menopausal women., Method: It was a 10 months cross sectional and observational study carried out on voluntary clinically healthy women aged at least 20 years. A complete clinical examination and measurement of the BMD by quantitative ultrasound measurement of the calcaneus was carried out. The BMD was calculated automatically by the apparatus with values in g/cm2 and in T-score., Results: 367 women, mean age 52 year (range 20 and 89) were included in the study. 218 (59.4%) were menopausal. The average bone mineral density was 0.513 g/cm2 (+/- 0.141). The bone minera density reduction was progressive with age with a sharp slope after 70 years. The statistically significant reduction of BMD was associated with: menopause, lower or moderate physical activity, weekly consumption of milk product evaluated at less than the equivalent of a cup of yoghurt, cigarette smoking. Alcohol consumption and obesity had no significant influence on the distribution of BMD. Considering the T-score, 13.6% had osteoporosis, 46.6% osteopenia and 53.4% were normal. In the women of 50 years and above, 17.9% had osteoporosis against 0.6% in women below 50 years while above 70 years, 55.8% had osteoporosis., Conclusion: The BMD of urban Cameroonian women is comparable with that of other women in the world. Osteoporosis is seemingly also present as in the western world, but with relatively less fractures. These results need to be confirmed by studies with larger population size.

Aim: To determine the prevalence and the visual morbidity of juvenile glaucoma in an urban black population., Material and Methods: A retrospective analysis of 1343 files of glaucomatous patients was carried out from January 1991 to December 2001 at the Douala General Hospital in Cameroon (Central Africa). Ninety four of them had juvenile glaucoma. Of the patients, 54 (57.4%) were males and 40 (42.6%) were females. Each subject underwent the following investigations: visual acuity, visual field testing, slit lamp examination, applanation tonometry, gonioscopy, and optic disc examination and photographies after mydriasis., Results: The prevalence of juvenile glaucoma in our population was 0.4%. The mean patients age at diagnosis was 26 +/- 6.8 years (range, 10 to 35 years). Among them, 88.3% had a positive family history of glaucoma. The mean intraocular pressure at diagnosis was 28.2 +/- 9.3 mmHg (range: 14 to 56 mmHg). It was lower than 21 mmHg in 5.3% of the cases. The mean recorded cup/disc ratio at diagnosis was 0.7 +/- 0.3. It was equal to 1.0 in 25.6% of the cases. Gonioscopy showed that the angles were open, with no abnormal pigmentation, iris processes, or embryonic tissue. The prevalence of monocular and bilateral blindness was 3.2% and 33% respectively at the first examination. The affected eye was blind in 50% (6/12) of patients with unilateral juvenile glaucoma. The mean IOP of the treated 166 eyes with topical medications decreased from 28 +/- 8.7 mmHg (range: 15 to 56 mmHg) to 19.1 +/- 8 mmHg (range: 8 to 48 mmHg) after a follow-up period average 1.6 +/- 2.3 years (range: one month to 11 years). Trabeculectomy was required in 10 eyes. Follow-up period of surgery ranged from 1 to 8 years (mean 3.8 +/- 3.3 years). The mean IOP decreased from 30.8 +/- 14 mmHg (range: 17 to 54 mmHg) preoperatively to 15.7 +/- 4.6 mmHg (from 10 to 25 mmHg) postoperatively., Conclusion: This study confirms the high prevalence of juvenile glaucoma among black Cameroonian population. The screening, the treatment as well as the genetic studies of this glaucoma bump into strong economic contingencies in our regions. In the cases where topical medications were ineffective in controlling IOP, surgery was needed to obtain long-term pressure control.

Purpose: This study aimed to identify the ocular complications of HIV/AIDS in Cameroon and to determine if there is any correlation between their occurrence and the level of CD4 lymphocytes count., Material and Methods: This prospective study was carried out at the General Hospital, Douala, from October 2004 to September 2005. All HIV positive patients with known CD4 count were retained for the study. Each patient had an exhaustive ocular examination., Results: A total of 57 patients including 30 females (52.9%) and 27 males (47.4%) were examined. The mean age was 38.9 years +/- 10.3. The eye examination was pathological in 36 patients (63.2%) and normal in 21 patients (36.8%). An ocular complaint was the inaugural manifestation of the disease in 31.6% of patients. The principal lesions of the anterior segment were herpetic keratitis (10.5%) and herpes zoster ophthalmicus (12.3%). The most common posterior segment lesions were cytomegalovirus retinitis (14%) and uveitis (15.8%). The mean CD4 count in our series was 118.3/mm3 +/- 106.7. 91.7% of patients with ocular complications have a CD4 count of less than 200/mm3. A non linear correlation was found between the CD4 level and the occurrence of ocular complications., Conclusion: With the improvement of access to antiretroviral treatment, the ocular complications of HIV/AIDS are more common. The role of the ophthalmologist is therefore essential in the diagnosis and management of these patients.

A preliminary analysis of the distribution of snakes captured in Cameroon between 1999 and 2004 is presented in this study. This work helps to provide a better understanding of the distribution of the venomous snakes. The main focus of this study was to identify regions of high diversity of venomous species, a useful step towards developing a national strategy of snakebite care and antivenom distribution. We recorded 4,910 specimens of 150 species from 361 localities throughout Cameroon. Among the ten provinces in Cameroon, the southwest province recorded the highest number of venomous snakes. Diversity was less in the far-north province, but the high abundance of Echis ocellatus seems to be responsible for many snake bites in the region. Of all venomous snakes, the forest cobra Naja melanoleuca was the most abundant in the forest region. The humid savannah region was dominated by Causus maculatus while the Sahelian part by Echis ocellatus. Given the abundance and high snake bite cases of the latter in the region, snakebite care from a national point of view should begin from the far-north towards the forest region of the south-west Cameroon.

Aim: To study the particularities of late post-traumatic glaucoma with irido-corneal angle injuries in black Cameroonians., Material and Methods: Retrospective analysis of 1343 files of glaucomatous patients was carried out from January 1991 to December 2001 at the Douala General Hospital in Cameroon in Central Africa. Fifty seven of them had post-traumatic glaucoma. Of these 28 were secondary to irido-corneal angle injuries., Results: The prevalence of post-traumatic glaucoma related to irido-corneal angle injuries in our population was 2.1%. The mean patients age was 45.9 +/- 18.3 years (range, 17 to 67 years). The time from injury to diagnosis ranged from 1 year 4 months to 7 years (median: 3.7 years). The follow-up period ranged from 3 months to 5 years 6 months, with a mean of 1.7 +/- 1.9 years. The prevalence of monocular blindness was 61.9% and 81% at the first and last examination respectively. The mean intraocular pressure was 36.9 +/- 13.8 mmHg (range: 22 and 66 mmHg) at the first examination and 24.3 +/- 13 mmHg (range: 12 and 29 mmHg) at the last examination. The mean recorded cup/disc ratio was 0.8 +/- 0.2. It was equal to 1.0 in 61.9% of cases. Irido-corneal angle recession was the most common lesion (61.9%) followed by iridodialysis (38.1%) and cyclodialysis (14.3%). Normalization of the intraocular pressure was achieved with medical treatment in 23.8% and with trabelectomy in 12.3% of the cases. Neovascular glaucoma was found in 4.8% of the cases., Conclusion: The treatment of secondary post-traumatic open angle glaucoma is disappointing. The patients are young, the disease is advanced, and the compliance and follow-up are poor. The prevention of post-traumatic glaucoma is based on the control of ocular trauma and the periodic follow-up of patients with and history of non perforating injury of the eye.

Purpose: This study aimed to identify the characteristics of amblyopia in a group of strabismic patients in our environment in order to improve management., Methods: A prospective study was carried out in the General Hospital, Douala, from July 1991 to July 2003. All strabismic patients had a complete ophthalmological examination including an oculomotor evaluation and skiascopy after cycloplegia., Results: 330 patients were examined. The mean age at initial consultation was 13.97 years +/- 12.21. The prevalence of amblyopia was 80.46% in esotropia and 59.40% in exotropia. The precocity of strabismus, eccentric fixation, torticollis, presence of a vertical element and nystagmus were aggravating factors for amblyopia., Conclusion: In order to carry out early and coherent management of strabismus, it is important to train and inform all those who are involved in the care process.

The impact of neurocysticercosis in Africa is not well known, and its role in the occurrence of epilepsy is not well defined. The concomitant high prevalence of both diseases in this region suggests a causal association of cysticercosis and epilepsy. The few attempts to find such a link in Africa have yielded discordant data. In order to answer this question, we conducted a case-control study between June and August 1998 in the Bilomo village in Central Cameroon, where a recent study had demonstrated very high epilepsy prevalence of 58/1000. Ninety-three epilepsy patients and eighty-one age matched controls were included. All subjects were examined by a neurologist and serology for cysticercosis was performed using an ELISA method. Serologies for cysticercosis were positive in twenty-nine out of one hundred and seventy four patients (16.7%; 95% CI: 11.6-23.2). Seventeen cases (18.3%) and twelve controls (14.8%) had a positive serology The odd ratio was 1.3 (95% CI: 0.6-3.0). This study was not in favour of an epidemiological relationship between cysticercosis infection and epileptic disorders.

This article describes an ongoing research project designed to compile a database to promote pastoral development in the lowlands along the Logone and Chari Rivers in Cameroon. A number of sedentary and nomadic populations depend on these flood plains south of Lake Chad for their livelihood. However the natural resources of the area undergo sharp seasonal variations and sometimes become the property of sedentary groups. As a result nomadic communities experience difficulty not only in gaining access to grazing lands and water but also to quality health care (hospital centers, effective medication). The purpose of this study was to define institutional requirements necessary to ensure access to health care resources for both nomadic and sedentary groups. The main problem for the nomadic population is that, unlike the now defunct pre-colonial structures, today's institutions are not compatible with the subsistence strategies of rural populations. These findings suggest that new institutional frameworks for natural resource management could indirectly improve the health status of nomadic pastoralist.

Aim: Aqueous extracts of Zingiber officinale and Pentadiplandra brazzeana were tested for their possible androgenic activity in male Wistar rats., Methods: The aqueous extracts of the two plants were gavaged separately to 2 groups of rats at a similar dose of 600 mg middot kg(-1) middot day(-1) for 8 days. At the end of the treatment, the animals were killed and the blood, testis, epididymis, seminal vesicles and prostate were collected for biochemical analysis., Results: The aqueous extract of Z. officinale significantly increased in the relative weight of the testis, the serum testosterone level, testicular cholesterol level and epididymal a-glucosidase activity. The aqueous extract of P. brazzeana significantly increased the weights of the testis, seminal vesicles and prostate. It also significantly increased the serum and testicular testosterone level. The fructose, alpha-glucosidase and cholesterol levels in P. brazzeana-treated rats were increased by 28 %, 35 % and 114 %, respectively., Conclusion: The aqueous extracts of both P. brazzeana and Z. officinale have an androgenic activity, which seems to be more potent with P. brazzeana than with Z. officinale.

The study of 102 teleost freshwater fishes of Sanaga basin in Cameroon revealed the presence of three myxosporean species, among which two were new. Host fishes were of three families: Centropomidae, Cichlidae and Characidae. New species were identified as Henneguya mbakaouensis sp. nov., a gill parasite of Lates niloticus and Myxobolus nounensis sp. nov. found in the kidney and spleen of Sarotherodon galilaeus and Tilapia mariae. Myxobolus hydrocyni Kostoïngue & Toguebaye, 1994, previously described in Chad, was also found in Cameroon; complementary informations were given on that parasite which seemed to be specific to its host.

Pediatric ophthalmology is poorly developed in Cameroon. However, efforts are being made to collect data essential for the development of national strategies to combat blindness. We relate our experience, within this framework, at a large public hospital in Cameroon. We carried out a retrospective study covering the period from June 1993 to May 1998, studying the medical files of children under the age of 15 years with ocular traumatism. Data were collected from 144 files. The frequency of ocular/orbital injury was 7.8% and was the third most common condition, after ametropia and kerato-conjunctivitis, in this population. The mean age of the children was 7 years and 3 months and more boys (64%) than girls were affected. Ocular lesions were due to contusion in 83.3% of cases. The principal causes of the trauma were children's games (40.2%), and punishment by parents or teachers (23.7%). The ocular lesions were similar to those described in previous studies. Infection was rare, because the interval from trauma to consultation was very short. The functional prognosis was severe, with 24.3% of patients having final vision less than 1/10. We recommend that children should be informed about the dangers of violent games and that parents and teachers should be made aware of the dangers associated with brutality towards children. Finally, ophthalmologists should ensure that the injured eye is treated rapidly and carefully so as to minimize functional sequelae.